Educational inequalities in health in Poland during the post-communist transition period

Wiktoria Wroblewska, Warsaw School of Economics

Since the beginning of the transformation in Poland, a systematic growth in life expectancy has been observed for both sexes. From 1991 to 2006, life expectancy at birth increased by 5 years for men and 4.5 years for women to reach 70.9 years for men and 79.6 years for women in 2006. However, different social groups enjoyed different shares in the observed gains in the total life expectancy as well as improvement in the health status. The aim of the study is to evaluate educational patterns of both self- rated health and mortality in Poland over the period of transition. The cross-sectional data were used to examine educational differences in the total mortality and in cause-specific mortality from1990 and 2002. Age standardised mortality rates were calculated for men and women aged between 25 and 69 years. The data from two Health Surveys 1996 and 2004 were used to evaluate the self-rated health. The age-standardised prevalence, adjusted odds ratios (OR) with 95% confidence intervals and the concentration index (CI) were calculated to measure the educational inequality in health statuses in Poland. The obtained results confirmed a significance of the education level on the occurrence of inequalities in health of men and women. At each stage of life, the higher mortality is recorded among persons of the lower education level. Over the recent years, the educational-related differences have still deepened, especially in the male population. The study revealed that a low educational level is very important determinant of poor health: for women with a primary education the odds of having poor less than good health were almost four times higher than those of women with a tertiary education (OR=4,36 in 2004 and OR=3,61 in 1996); for men this odds ratio was above three (OR= 3,71 in 2004 and OR=3,16 in 1996).